Neighborhoods and obesity in later life.

OBJECTIVES We examined the influence of neighborhood environment on the weight status of adults 55 years and older. METHODS We conducted a 2-level logistic regression analysis of data from the 2002 wave of the Health and Retirement Study. We included 8 neighborhood scales: economic advantage, economic disadvantage, air pollution, crime and segregation, street connectivity, density, immigrant concentration, and residential stability. RESULTS When we controlled for individual- and family-level confounders, living in a neighborhood with a high level of economic advantage was associated with a lower likelihood of being obese for both men (odds ratio [OR] = 0.86; 95% confidence interval [CI] = 0.80, 0.94) and women (OR = 0.83; 95% CI = 0.77, 0.89). Men living in areas with a high concentration of immigrants and women living in areas of high residential stability were more likely to be obese. Women living in areas of high street connectivity were less likely to be overweight or obese. CONCLUSIONS The mechanisms by which neighborhood environment and weight status are linked in later life differ by gender, with economic and social environment aspects being important for men and built environment aspects being salient for women.

[1]  Steve Wing,et al.  The contextual effect of the local food environment on residents' diets: the atherosclerosis risk in communities study. , 2002, American journal of public health.

[2]  L. F. Alwitt,et al.  Retail Stores in Poor Urban Neighborhoods , 1997 .

[3]  J. Cawley An instrumental variables approach to measuring the effect of body weight on employment disability. , 2000, Health services research.

[4]  M. Rowland,et al.  Self-reported weight and height. , 1990, The American journal of clinical nutrition.

[5]  A. Kriska,et al.  Objective measures of neighborhood environment and physical activity in older women. , 2005, American journal of preventive medicine.

[6]  Richard P Troiano,et al.  The association between urban form and physical activity in U.S. adults. , 2002, American journal of preventive medicine.

[7]  Fuzhong Li,et al.  Neighborhood-level influences on physical activity among older adults: a multilevel analysis. , 2004, Journal of aging and physical activity.

[8]  R. Brownson,et al.  Multilevel modelling of built environment characteristics related to neighbourhood walking activity in older adults , 2005, Journal of Epidemiology and Community Health.

[9]  Lawrence D. Frank,et al.  The Built Environment and Human Activity Patterns: Exploring the Impacts of Urban Form on Public Health , 2001 .

[10]  Baoping Shang,et al.  The health and cost consequences of obesity among the future elderly. , 2005, Health affairs.

[11]  Ross C Brownson,et al.  What Constitutes an Obesogenic Environment in Rural Communities? , 2006, American journal of health promotion : AJHP.

[12]  Richard G. Rogers,et al.  Race Differentials in Obesity: The Impact of Place∗ , 2005, Journal of health and social behavior.

[13]  F. Chaloupka,et al.  Availability of physical activity-related facilities and neighborhood demographic and socioeconomic characteristics: a national study. , 2006, American journal of public health.

[14]  Emily Stevens,et al.  Features of the neighborhood environment and walking by U.S. adults. , 2005, American journal of preventive medicine.

[15]  R. Brownson,et al.  Environmental and policy determinants of physical activity in the United States. , 2001, American journal of public health.

[16]  Dawn K Wilson,et al.  Perceptions of Neighborhood Sidewalks on Walking and Physical Activity Patterns in a Southeastern Community in the US. , 2006, Journal of physical activity & health.

[17]  V. Freedman,et al.  Neighborhoods and disability in later life. , 2008, Social science & medicine.

[18]  M. Grossman,et al.  An Economic Analysis of Adult Obesity: Results from the Behavioral Risk Factor Surveillance System , 2002, Journal of health economics.

[19]  A. Mokdad,et al.  Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. , 2003, JAMA.

[20]  T. Glass,et al.  Neighborhoods and obesity in older adults: the Baltimore Memory Study. , 2006, American journal of preventive medicine.

[21]  S. Asch,et al.  You are where you shop: grocery store locations, weight, and neighborhoods. , 2006, American journal of preventive medicine.

[22]  Martin A. Andresen,et al.  Obesity relationships with community design, physical activity, and time spent in cars. , 2004, American journal of preventive medicine.

[23]  Ian Janssen,et al.  Vascular Risks and Management of Obesity in Children and Adolescents , 2006, Vascular health and risk management.

[24]  J. Sallis,et al.  Neighborhood-based differences in physical activity: an environment scale evaluation. , 2003, American journal of public health.

[25]  A. Mokdad,et al.  The spread of the obesity epidemic in the United States, 1991-1998. , 1999, JAMA.

[26]  K. Flegal,et al.  Prevalence of overweight and obesity in the United States, 1999-2004. , 2006, JAMA.

[27]  J. Wit,et al.  Adult height corrected for shrinking and secular trend. , 2003, Annals of human biology.

[28]  Penny Gordon-Larsen,et al.  Built and social environments associations with adolescent overweight and activity. , 2006, American journal of preventive medicine.

[29]  Shuming Bao,et al.  Neighborhood racial composition, neighborhood poverty, and the spatial accessibility of supermarkets in metropolitan Detroit. , 2005, American journal of public health.

[30]  R. Pate,et al.  Correlates of recreational and transportation physical activity among adults in a New England community. , 2003, Preventive medicine.

[31]  E. Reither,et al.  A multilevel analysis of race, community disadvantage, and body mass index among adults in the US. , 2004, Social science & medicine.

[32]  M. Miller Agency , 2010 .

[33]  B. Ainsworth,et al.  Personal, social, and physical environmental correlates of physical activity in African-American women in South Carolina. , 2003, American journal of preventive medicine.

[34]  R. Scribner,et al.  Fast food, race/ethnicity, and income: a geographic analysis. , 2004, American journal of preventive medicine.

[35]  A. D. Diez Roux,et al.  Neighborhood characteristics associated with the location of food stores and food service places. , 2002, American journal of preventive medicine.

[36]  Fuzhong Li,et al.  A Multilevel Path Analysis of the Relationship Between Physical Activity and Self-Rated Health in Older Adults , 2004 .

[37]  N. Sastry,et al.  Neighborhood and Family Effects on Children's Health in Los Angeles , 2003 .

[38]  T. Koepsell,et al.  Association of the built environment with physical activity and obesity in older persons. , 2007, American journal of public health.

[39]  Ariane L. Bedimo-Rung,et al.  Proximity to School and Physical Activity Among Middle School Girls: The Trial of Activity for Adolescent Girls Study. , 2006, Journal of physical activity & health.